San Diego Investigator - Child Custody, Infidelity, Family Lawhttp://kelsaypi.com
Private Investigator in San Diego - Surveillance, Locate ServicesMon, 02 Mar 2015 19:43:22 +0000en-UShourly1http://wordpress.org/?v=4.1.1Bill for injured workers with uninsured employershttp://kelsaypi.com/bill-for-injured-workers-with-uninsured-employers/
http://kelsaypi.com/bill-for-injured-workers-with-uninsured-employers/#commentsFri, 01 Aug 2014 04:49:08 +0000http://kelsaypi.com/?p=326If you’re an injured worker with an employer who doesn’t have insurance, receiving worker’s compensation benefits can be greatly delayed.
But thanks to a bill introduced by Assembly member Luis Alejo, D-Watsonville, that was signed by Gov. Jerry Brown on July 21, that process is set to speed up. The bill will also support the identification, reporting and enforcement of illegally uninsured employers, with the hopes of increasing employer compliance with workers’ compensation laws.

The bill, AB 1746, came out of Alejo’s “There Ought to be a Law” contest he held last year, which solicited ideas for news from the public. This idea came from Dori Rose Inda, who is now the CEO at Salud Para La Gente in Watsonville, where she fights for access to health care, workers’ rights and consumer protections.

“This bill is truly a win-win,” Alejo in a statement. “It will help a vast number of low wage workers and also benefit businesses that play by the rules. It will save the state money and put hardworking Californians back to work. I truly thank Dori for bringing me this great idea.”
This is the first bill introduced by Alejo that has been signed by Brown this year, and will become law Jan. 1, 2015.

Dr. Arnold P. Nerenberg of Whittier said Tuesday he was grateful federal agents caught him. In an emotional speech, the 72-year-old told the judge he overbilled patients whose costs were covered by the government so he could treat those who could not pay.

In an agreement with prosecutors, Nerenberg pleaded guilty to one count of fraud. Six other counts were dismissed. He was sentenced to five years’ probation with the first 12 months on home confinement and electronic monitoring. He also must pay restitution of $172,754.

After his arrest, Nerenberg said a friend told him: “It’s too bad you got caught.” He said he disagreed.

“I think it’s too bad I committed the crime. I’m grateful I got caught,” Nerenberg said. “I wanted to stop what I was doing, but I was caught in an inner struggle. … I was grateful for the vigorous federal intervention.”

Two ex-postal workers indicted with Nerenberg in the 2011 case reached plea agreements and were sentenced earlier to probation and restitution, according to Nerenberg’s attorney, Diane C. Bass. They were charged with filing false statements to obtain federal employee compensation from the U.S. Postal Service for medical claims.

U.S. District Judge Christina A. Snyder said she considered letters from Nerenberg’s family and friends in deciding his sentence.

The prosecutor, Assistant U.S. Attorney Rozella Oliver, said she was persuaded that there were mitigating factors weighing in Nerenberg’s favor. She agreed home confinement was an appropriate sentence.

“Dr. Nerenberg has done far more good than harm,” said Bass, who noted that former patients were in the courtroom to support him. She said he had suffered public humiliation and would probably lose his medical license.

“My remorse is profound,” said Nerenberg, who spoke of his pain when agents went to interview his former patients.

“They came to me for healing, and the harm that came to them _ I just couldn’t face it,” he said, his voice breaking.

Nerenberg said he is turning his life around, concluding, “I have not always lived with honor, but I will die with honor.”

The judge said she was impressed with Nerenberg’s remarks and felt he was sincerely sorry. “But this is a very serious crime, defrauding the government of $172,000, whether with good or bad intentions,” Snyder said. She then imposed his sentence.

SAN DIEGO — The owners and employees of four San Diego County businesses face charges for allegedly committing various types of insurance fraud, including encouraging employees to collect unemployment while getting paid on the job.

A grand jury last month handed down the indictments against 14 people, some of them owners of businesses in Encinitas, Escondido and National City. The District Attorney’s Office announced the indictments Tuesday.

The defendants are accused of committing workers’ compensation fraud, unemployment fraud and tax evasion — crimes that cheated insurance companies and the state tax board out of $1.5 million, prosecutors said.

Four pleaded not guilty on Jan. 6 in San Diego Superior Court. Five others pleaded not guilty Tuesday afternoon, and warrants were expected to be issued for four defendants who did not appear in court.

All of the defendants who were arraigned Tuesday in connection with the case were employees of Christina Engineering of Escondido, said prosecutor Jeanie Cetlinski outside the courtroom.

A fifth person, Jessica Hutchison, 35, was in court for a status conference. She is charged in a separate case with embezzling $1.2 million from Christina Engineering.

Among those indicted are:

• Russ E. Kubart, 50, of A1 Patio and Remodeling Experts in Encinitas, who is accused of telling an employee to claim he was injured at home instead of at a job site because Kubart did not have workers’ compensation insurance. Prosecutors put that loss at $160,000, according to a news release.

• Marcos Castaneda, 46, of Quality Way Building Maintenance in National City is accused of lying about his payroll in order to receive reduced workers’ compensation premiums. That loss was valued at more than $133,000.

• Rufino Aguiluz, 46, and his wife, Maria Foulk, 53, both of Rufino’s Landscaping in Escondido, are accused of failing to report payroll to various insurance providers and tax collectors. That loss amounted to more than $952,000, prosecutors said.

• Ten employees of Christina Engineering in Escondido are accused of receiving unemployment benefits while they were being paid to work, which they were encouraged to do by their employers. Prosecutors said the loss was $350,000.

]]>http://kelsaypi.com/business-owners-face-insurance-fraud-charges/feed/0Salinas man pleads no contest to fraudhttp://kelsaypi.com/salinas-man-pleads-no-contest-to-fraud/
http://kelsaypi.com/salinas-man-pleads-no-contest-to-fraud/#commentsThu, 23 Jan 2014 02:53:20 +0000http://kelsaypi.com/?p=310Ricardo Casillas, 32, of Salinas, has pleaded no contest to one count of making a material misrepresentation in order to obtain a lower workers’ compensation insurance premium, one count of insurance fraud and one count of willfully failing to file payroll tax returns with intent to evade tax, the Monterey County District Attorney’s office said.

Casillas owns Casillas Transportation Services and Desert Express Transportation Lines. In 2009, AIG/Chartis, an insurance carrier, sent a referral of a potential insurance premium fraud case to the Monterey County District Attorney’s Office, Workers’ Compensation Fraud Unit. A joint investigation between the Monterey County District Attorney’s Office and the California Department of Insurance was initiated, but became complicated when investigators learned Casillas had an Arizona company and he was reporting employee wages to Arizona. Eventually, investigators determined that Casillas had set up a shell company in Arizona to report California employees to Arizona in order to reduce taxes owed and reduce his insurance premiums, prosecutors said. The investigation revealed that from April 2008 through August 2009, Casillas obtained workers’ compensation insurance reporting his California employees as Arizona employees who did not drive interstate and only drove “short hauls,” an option that is not available in California. Investigators found that drivers actually spent at least 90 percent of their driving time in California, prosecutors said. Casillas dropped his workers’ compensation insurance and did not have coverage during 2009 through 2011.

In 2011, while the case was being investigated, Casillas obtained workers’ compensation insurance through the State Compensation Insurance Fund, indicating he had three California employees and seven Arizona employees who sometimes traveled out of California to Yuma, Arizona, prosecutors said. In fact, Casillas employed between 15 and 20 California employees, they said. Once it was determined all of the employees were in California, the Employment Development Department joined the investigation to determine the amount of payroll taxes Casillas failed to report and pay from 2007 through 2011, the DA’s office said.

Sentencing is scheduled for March 28 in front of Monterey County Superior Court Judge Wendy Duffy. The maximum sentence for the charges is six years, eight months, but Casillas will be placed on probation for up to 10 years, the DA’s office said. Restitution to the victims is estimated to be $108,107 and an additional $186,487 in estimated restitution is attributed to the Employment Development Department (EDD) for a total estimated restitution of $294,594 plus fines and penalties.

Maybe now the National Football League (NFL) will see fit to reward the city of Los Angeles by giving it a franchise after the state of California provided a huge windfall for its billionaire owners at the expense of former players.

Assembly Bill 1309, signed by Governor Jerry Brown Tuesday, tightens up the state’s workers’ compensation rules, which have made California a magnet for out-of-state former football players seeking help with medical conditions linked to their hand-to-hand combat on the field.

California was one of the few states that allowed people to collect workers’ comp for cumulative trauma injuries that may not have been evident at the time of retirement. That could include joint and muscular problems, but most prominently opened the door for claims related to concussions and other brain-related maladies, like Alzheimer’s.

The state also allowed claims by athletes who played for non-California teams, but visited on occasion for games or training. That covered most professional athletes.

The Los Angeles Times reported that more than 3,400 former NFL players have filed the workers’ comp claims in California since 2006. Most of them were from out of state. Taxpayers are not on the hook for the money, which mostly comes out of the pocket of employers and their insurance companies. So California’s new law is a windfall for team owners and their insurers.

These savings could likely dwarf, over the long haul, a settlement the NFL made with former players in August. That deal, considered a bargain by most observers, commits the league to paying $765 million to 4,500 men who had sued in federal court, claiming that the league had suppressed information about the dangers of head trauma.

Those claims are also the subject of a two-part PBS Frontline documentary entitled “League of Denial: The NFL’s Concussion Crisis.” The first part aired Tuesday and the next part is scheduled for October 15. The series investigates what the league knew about the dangers from head trauma and when it knew it.

The issue has been discussed for years and was beginning to make headlines in 2007, even as the league denied any links between its violent sport and the deteriorating mental conditions of the men who played it. But it received national attention when a greatly diminished former All-Pro linebacker Tiaina Baul “Junior” Seau Jr. killed himself in 2012, three years after retiring.

There was speculation that the popular Seau had suffered head injuries during his career with the San Diego Chargers and a subsequent study of his brain by the National Institutes of Health found evidence of chronic traumatic encephalopathy (CTE).

Although the NFL successfully settled the biggest lawsuit it faced, other suits have been filed and more are certain to come. The league has made numerous changes to its rules in an effort to make football safer, but there is no getting around the dangers inherent in a game where warriors smash into each other with frightening ferocity. Violence is at the heart of the game.

It remains to be seen if the California legislation, which affects only profession football, baseball, soccer, hockey and basketball, will be challenged in court. Organized labor was among its opponents, fearful that the ban on out-of-state filers could eventually be applied to a broad range of occupations, including sales people, truck drivers and flight attendants.

Deion Sanders is far from the only present-day employee of the National Football League to have filed a workers’ compensation claim in California claiming head or brain injuries.

At least 43 present-day assistant coaches and front office personnel who previously played in the league have filed claims against their former teams in the last half-dozen years, records show. In addition, more than six television analysts for NFL Network, which is owned by the league, have made such claims.

Well over 90% of the claims allege serious head or brain trauma, The Times found in an analysis of filings from the California Division of Workers’ Compensation. A list of NFL employees with claims is here.

The NFL has worked hard to present a unified front on its growing brain injury problem, but the large number of workers compensation claims filed by its own employees serve as an important indication of how deeply the problem of brain injuries has penetrated the country’s most popular professional sport.

Four Green Bay Packers employees have made claims – more than any other team — including assistant head coach Winston Moss and director of pro personnel Alonzo Highsmith.

The broadcast booth at NFL Networks is also crowded with former players suffering injuries serious enough to seek compensation. The most prominent is Sanders, who the Times reported last week had made a claim including head injuries in 2010, yet later criticized ex-players who were suing the NFL in federal court over the concussion issue.

His claim is still pending, as are claims by Brian Baldinger, Bucky Brooks, Willie McGinest and Darren Sharper. Fellow on-air talent Michael Irvin and Marshall Faulk also filed claims that have been settled.

Irvin received a $249,000 cash settlement from the Dallas Cowboys and its insurer in 2011. That same year Faulk received an award worth at least $356,000, plus lifetime medical coverage for his injuries, state records show.

The claims are made against the individual’s former teams, rather than their current employers. As with all workers’ compensation cases, awards or settlements are the responsibility of the employer or its insurer, not taxpayers.

On Monday, a bill that would prevent most players from making claims in California was given final approval by the state Legislature and sent to Gov. Jerry Brown for review. He has until Oct. 13 to sign or veto the bill, AB 1309, which would bar athletes who played for out-of-state teams from filing claims here, as well as California-based athletes who played fewer than two seasons in the state.

It applies only to professional football, basketball, baseball, ice hockey and soccer players. Athletes from other sports, as well as workers in industries that perform some of their duties in California despite not being employed here – think trucking or airlines — would not be affected.

Critics of the legislation worry that it will leave hundreds, if not thousands, of former players with serious medical conditions with no options to seek financial or medical help from the teams that employed them.

Many will have no option but to seek relief from state and federal programs such as Medicaid and Social Security Disability, they argue, putting a significant financial burden on taxpayers.

]]>http://kelsaypi.com/dozens-of-nfl-coaches-tv-analysts-file-head-brain-injury-claims/feed/0A Newport man pleads guilty to stealing winehttp://kelsaypi.com/a-newport-man-pleads-guilty-to-stealing-wine/
http://kelsaypi.com/a-newport-man-pleads-guilty-to-stealing-wine/#commentsThu, 05 Sep 2013 01:23:31 +0000http://kelsaypi.com/?p=298A wine storage business owner in Irvine pleaded guilty Friday to stealing $2.7 million worth of wine from his clients and under- reporting about $3.5 million in payroll taxes in a plea deal that got him six years in prison.

George Osumi II, 65, of Newport Beach, created multiple companies between 2001 and 2011, using the names of relatives and friends so he could avoid tax liability while operating the businesses, according to Deputy District Attorney Shaddi Kamiabipour.

Osumi cheated the State Compensation Insurance Fund of about $814,000 by under-reporting payroll between December 2001 and March 2006, Kamiabipour said.

From May 2004 through October 2011, he used a former business associate’s name to get an American Express Card, which he used to make unauthorized purchases, the prosecutor said.

Osumi also withheld state taxes and disability insurance benefits payments from his employees from 2009 through 2011, but he pocketed the money instead of forwarding it to the state, Kamiabipour said.

One of his employees was unable to collect unemployment because of the theft, Kamiabipour said.

“One employee who wanted to retire couldn’t because her Social Security (benefits) weren’t paid into for several years,” Kamiabipour said. “One employee almost got arrested because the (payroll) checks he tried to cash wouldn’t clear. At one point the police thought it was someone going around passing bad checks.”

Osumi’s crimes left “a lot of collateral damage and direct damage, and that’s why we put our foot down and said this is a state prison case,” Kamiabipour said.

From January 2008 through June 21, 2011, Osumi operated Legend Cellars Inc. in Irvine, a business that stored wine at a controlled temperature. Three times, Osumi broke into private storage lockers and stole their wine, which was worth about $2.7 million.

To conceal the theft, Osumi left behind bottles of a much cheaper vintage, Kamiabipour said.

In 2008, Osumi hired a friend, who was unaware the wine was stolen, to auction off pilfered wine to split the proceeds, Kamiabipour said.

Osumi put about $280,000 into his business account and used the money for personal expenses and legal fees, Kamiabipour said.

Between July 20, 2011 and June of last year, Osumi auctioned off some stolen wine for about $310,000, Kamiabipour said.

Osumi was given credit for 674 days in custody. He will return to court Nov. 1 for a hearing to determine how much restitution he owes his victims, Kamiabipour said.

“There’s no indication he can pay it,” Kamiabipour said. “He’s been living off of his stealing for years.”

If Osumi has a windfall of money, such as from a lottery, the proceeds would be used to pay victims, Kamiabipour said.

The defendant’s own son and daughter were victims in the case. Their father used them as “pawns” in the thievery, and initially investigators thought the two were involved, Kamiabipour said.

Osumi could have faced up to 80 years in prison if he had been convicted at trial, but prosecutors were “satisfied” with his punishment, Kamiabipour said.

]]>http://kelsaypi.com/a-newport-man-pleads-guilty-to-stealing-wine/feed/0Buena Park company owner convicted of under-reporting payroll to SCIFhttp://kelsaypi.com/buena-park-company-owner-convicted-of-under-reporting-payroll-to-scif/
http://kelsaypi.com/buena-park-company-owner-convicted-of-under-reporting-payroll-to-scif/#commentsThu, 15 Aug 2013 03:00:07 +0000http://kelsaypi.com/?p=285A president of a cleaning company was convicted and sentenced today for underreporting his payroll by over $8 million resulting in a premium loss of over $898,000. Loksarang Dinkar Hardas, 53, Buena Park, pleaded guilty today to six felony counts of misrepresenting facts to State Compensation Insurance Fund (SCIF), three felony counts of misrepresenting facts to Worker’s Compensation Insurance company, and a sentencing enhancement for committing an aggravated white collar crime.

Hardas was sentenced to five years in state prison stayed pending successful completion of 10 years of formal probation, $250,000 fine, and restitution payment of $898,000.

California law requires that all employers maintain workers’ compensation insurance for their employees. Payroll records showing the number of employees and their income must be submitted to both the workers’ compensation insurance company and EDD, who oversee the collection of payroll taxes. Workers’ Compensation Insurance rates are determined by a formula, which takes into consideration the number and type of employees and the company’s history of injury claims.

Premium insurance fraud is committed when an employer intentionally misrepresents to the insurance company the number of employees, the type of work performed, the amount of payroll, and the loss history. Many times employers will hide their employees under other uninsured business entities, and if and when an employee is injured, that employee will be transferred over to the insured entity. Since the insurance is for the benefit of the employee, an insurance company is liable for these unknown employees. These illegal misrepresentations allow deceitful employers to calculate and purchase workers’ compensation insurance at a significantly lower premium rate, or to avoid purchasing the insurance at all. This practice places their competitors at a disadvantage because it forces them to compete against a company with fraudulently lower operating costs.

Premium fraud drives up the cost of insurance premiums for legitimate businesses that pay higher rates for their employees’ workers’ compensation insurance coverage. These legitimate businesses are less competitive against fraudulent companies who are able to under-bid their competitors due to lower business costs resulting from insurance fraud. This also endangers injured employees who may be denied workers’ compensation benefits intended to meet their physical, psychological, and financial needs for a work-related injury.

Awesome Products has been operating since 1998 as a manufacturing and distribution company for household and commercial cleaning products across the nation.

In 2001, Hardas applied and received a SCIF policy for Awesome Products but the defendant did not inform SCIF that he leased a majority of his labor from one of his three leasing companies he owned.

On July 10, 2008, Hardas insured his labor leasing companies with The Hartford insurance company but failed to disclose his policy with SCIF.

From July 10, 2008, to Dec. 2, 2010, Hardas underreported over $8 million of his payroll to both SCIF and The Hartford which resulted in a premium loss of $898,000.

SCIF began investigating the fraud after an employee working for one of the labor leasing companies, owned by the defendant, filed an insurance claim after suffering an injury at work. SCIF learned that the employee worked out of the same facility as Awesome Products but was employed through one of the labor leasing companies owned by the defendant.

SCIF reported this to the Orange County District Attorney Bureau of Investigation who investigated this case.

Deputy District Attorney Debbie Jackson of the Insurance Fraud Unit prosecuted this case.